NORMANAL F.C. TABLET

Indications

• Chronic venous insufficiency
• Hemorrhoids
• Leg edema
• Varicose veins

Dosage

Children: Refer to the BNF for Children for specific dosing information.

Adults: Refer to the BNF for specific dosing information.

Mechanism of action

Diosmin helps to maintain circulatory system structure and function, particularly vein strength and competence. Although the molecular mechanism of action is not fully established, diosmin is suggested to bind to the aryl hydrocarbon receptor, although the clinical relevance to vascular function remains unclear. It has been observed to influence the metabolism of noradrenaline in varicose veins, potentially benefiting vascular health.

Pharmacodynamics

Diosmin supports circulatory health through multiple mechanisms, including improving lymphatic drainage, enhancing microcirculation, and increasing venous tone and elasticity. It has shown to reduce oxidative stress by scavenging free radicals and lowering levels of inflammatory markers such as TNF alpha and IL-6. Clinical studies have demonstrated a reduction in edema and leg circumference in patients with chronic venous conditions after diosmin therapy.

Pharmacokinetics

Diosmin is well-absorbed from the gastrointestinal tract and undergoes extensive metabolism, primarily in the liver. The elimination half-life and specific metabolic pathways have not been extensively detailed, but it is known to be excreted in urine. The pharmacokinetic parameters may vary based on individual patient factors.

Adverse effects

• Gastrointestinal discomfort
• Nausea
• Diarrhea
• Headache
• Allergic reactions

Precautions

• Use with caution in patients with hypersensitivity to diosmin or any of its components.
• Consult a healthcare provider before use in patients with underlying health conditions.

Pregnancy

The safety of diosmin in pregnancy has not been established. Use only if clearly needed and after assessing risks and benefits.

Breast-feeding

It is unknown whether diosmin is excreted in human milk. Caution is advised when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Diosmin 500 mg tablets
• Diosmin 1000 mg tablets

Indications

• Chronic venous insufficiency
• Hemorrhoids
• Varicose veins
• Hypertension
• Antioxidant support

Dosage

Children: Refer to BNF for Children for specific dosing guidance.

Adults: Refer to BNF for specific dosing guidance.

Mechanism of action

Hesperidin exerts its effects through various mechanisms, including the modulation of nitric oxide synthesis, which leads to vasodilation and improved blood circulation. It also possesses anti-inflammatory properties and can inhibit the activity of certain enzymes involved in oxidative stress, contributing to its antioxidant effects.

Pharmacodynamics

Hesperidin has been shown to enhance capillary resistance and reduce permeability, which can aid in the management of conditions like chronic venous insufficiency. Its antioxidant effects help to neutralize free radicals, thereby protecting cells from oxidative damage. Additionally, hesperidin may have a role in lipid metabolism and lowering cholesterol levels.

Pharmacokinetics

After oral administration, hesperidin is rapidly absorbed, with peak plasma concentrations occurring within a few hours. It undergoes extensive metabolism in the liver to yield various metabolites. The elimination half-life is variable but generally ranges from several hours to a day. Hesperidin and its metabolites are primarily excreted via urine.

Pregnancy

There is insufficient reliable information regarding the safety of hesperidin during pregnancy. Consult a healthcare provider for guidance.

Breast-feeding

Limited data is available on the excretion of hesperidin in breast milk. Caution is advised, and a healthcare provider should be consulted before use.

Storage

Store in a cool, dry place away from direct sunlight and moisture.

Mechanism of action

Diosmin helps to maintain circulatory system structure and function, particularly vein strength and competence. The molecular mechanism of action of diosmin has not been established. Several resources indicate that diosmin binds to the aryl hydrocarbon receptor, however clinical relevance to vascular function is unknown. One study demonstrates that oral diosmin exerts effects on the in vitro metabolism of noradrenaline by varicose veins, potentially benefitting vascular health.

Pharmacodynamics

Diosmin is a venoactive drug supporting circulatory health through various actions on blood vessels; it supports lymphatic drainage and improves microcirculation while increasing venous tone and elasticity. For these reasons, diosmin is frequently taken by individuals with chronic venous disease to support vascular health and has been demonstrated to improve quality of life. In addition to the above effects, diosmin exerts antioxidant activity and scavenges oxygen free radicals, reducing levels of oxidative stress normally detected through biomarkers such as prostaglandins isoprostane precursors. In one clinical study, mean content of TNF alpha, VEGF-C, VEGF-A IL-6, in addition to FGF2 were decreased by after the therapy with diosmin; findings were statistically significant. Additionally, a decrease in edema and mean leg circumference of patients taking diosmin for three months was observed in a clinical study. Diosmin has been demonstrated to enhance the metabolism of glucose in diabetic disorders.